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Cognitive dysfunction in older subjects with diabetes mellitus: impact on diabetes self-management and use of care services. All Wales Research into Elderly (AWARE) Study
Sinclair AJ, Girling AJ, Bayer AJ.. Diabetes research and clinical practice, 2000-12-01
Topic: Risk, prevention and care in population studies
Objective To determine whether cognitive impairment is associated with changes in self-care behaviour and use of health and social services in older subjects with diabetes mellitus. Research design and methods This was a community based, case-control study of subjects registered with general practices participating in the All Wales Research into Elderly (AWARE) Diabetes Study. The 396 patients aged 65 years or older with known diabetes mellitus were compared with 393 age- and sex-matched, non-diabetic controls. Adjusted odds ratio estimates of normal performance on Mini-Mental State Examination (MMSE) and Clock Drawing Test (numbers and hands) were determined. Information on self-care behaviours and use of services was obtained. Results A total of 283 (71%) diabetic subjects scored 24 or more on MMSE, compared with 323 (88%) of controls (OR 0.54, P Conclusions Elderly subjects with predominantly Type 2 diabetes mellitus display significant excess of cognitive dysfunction, associated with poorer ability in diabetes self-care and greater dependency. Routine screening of cognition in older subjects with diabetes is recommended.
Key findings
- Objective To determine whether cognitive impairment is associated with changes in self-care behaviour and use of health and social services in older subjects with diabetes mellitus.
- The 396 patients aged 65 years or older with known diabetes mellitus were compared with 393 age- and sex-matched, non-diabetic controls.
- Results A total of 283 (71%) diabetic subjects scored 24 or more on MMSE, compared with 323 (88%) of controls (OR 0.54, P<0.0005).
Why it matters
In a community study in Wales, 71% of 396 people aged 65+ with diabetes scored in the normal range (24 or more) on a standard memory and thinking test (MMSE), compared with 88% of age- and sex-matched people without diabetes (odds ratio 0.54). The authors report that these thinking problems went along with poorer diabetes self-care and greater dependency, and they recommend routine cognitive screening for older people with diabetes. This one-time comparison shows an association only. It does not show that diabetes causes dementia, and it tested no treatment.
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Study details
- Study designcase-control study
- Participants396
- Effect sizeOR 0.54
- Evidence strengthModerate
How this study scored 60/100
Published in a peer-reviewed journal, and it is a case-control study. Scored zero for randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Diabetes research and clinical practice) |
| Journal's citation record | 2 / 4 | Diabetes Research and Clinical Practice: journal h-index 181 (OpenAlex, 2026-10-29) |
| Study design | 6 / 12 | A case-control study |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2000 — older than 20 years, still counted |
| Sample size | 2 / 4 | 396 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 362 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 12.9 citations a year over 28 year(s) since 2000 |
| Impact for its field and year | 2 / 6 | Cited 2.9× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 7 other studies in this library |
| Still being cited | 2 / 4 | Cited 37 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Antony J. Bayer: h-index 58 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Birmingham: institution h-index 1,266 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | PubMed indexes it as a multicentre study |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 11106835) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 60 / 100 | — |
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Sinclair, A. J., Girling, A. J., & Bayer, A. J. (2000). Cognitive dysfunction in older subjects with diabetes mellitus: impact on diabetes self-management and use of care services. All Wales Research into Elderly (AWARE) Study. Diabetes research and clinical practice. https://doi.org/10.1016/s0168-8227(00)00195-9
Vancouver
Sinclair AJ, Girling AJ, Bayer AJ. Cognitive dysfunction in older subjects with diabetes mellitus: impact on diabetes self-management and use of care services. All Wales Research into Elderly (AWARE) Study. Diabetes research and clinical practice. 2000. doi:10.1016/s0168-8227(00)00195-9. PMID: 11106835.
BibTeX
@article{sinclair2000-11106835,
author = {Sinclair, A. J. and Girling, A. J. and Bayer, A. J.},
title = {{Cognitive dysfunction in older subjects with diabetes mellitus: impact on diabetes self-management and use of care services. All Wales Research into Elderly (AWARE) Study}},
journal = {Diabetes research and clinical practice},
year = {2000},
doi = {10.1016/s0168-8227(00)00195-9},
pmid = {11106835},
url = {https://doi.org/10.1016/s0168-8227(00)00195-9}
}
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